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EP1948061B1 - Enregistrements panoramiques stratifies en vue de la planification d'une implantation - Google Patents

Enregistrements panoramiques stratifies en vue de la planification d'une implantation Download PDF

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Publication number
EP1948061B1
EP1948061B1 EP06828885.1A EP06828885A EP1948061B1 EP 1948061 B1 EP1948061 B1 EP 1948061B1 EP 06828885 A EP06828885 A EP 06828885A EP 1948061 B1 EP1948061 B1 EP 1948061B1
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EP
European Patent Office
Prior art keywords
implants
panoramic
layer
panorama
implant
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Active
Application number
EP06828885.1A
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German (de)
English (en)
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EP1948061A1 (fr
Inventor
Nils Hanssen
Erwin Keeve
Lutz Ritter
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
SICAT GmbH and Co KG
Original Assignee
SICAT GmbH and Co KG
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Publication of EP1948061A1 publication Critical patent/EP1948061A1/fr
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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C1/00—Dental machines for boring or cutting ; General features of dental machines or apparatus, e.g. hand-piece design
    • A61C1/08—Machine parts specially adapted for dentistry
    • A61C1/082—Positioning or guiding, e.g. of drills
    • A61C1/084—Positioning or guiding, e.g. of drills of implanting tools
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C13/00—Dental prostheses; Making same
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B6/00—Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment
    • A61B6/50—Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment specially adapted for specific body parts; specially adapted for specific clinical applications
    • A61B6/51—Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment specially adapted for specific body parts; specially adapted for specific clinical applications for dentistry
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61C—DENTISTRY; APPARATUS OR METHODS FOR ORAL OR DENTAL HYGIENE
    • A61C9/00—Impression cups, i.e. impression trays; Impression methods
    • A61C9/004—Means or methods for taking digitized impressions
    • A61C9/0046—Data acquisition means or methods
    • A61C9/0053—Optical means or methods, e.g. scanning the teeth by a laser or light beam
    • A61C9/006—Optical means or methods, e.g. scanning the teeth by a laser or light beam projecting one or more stripes or patterns on the teeth

Definitions

  • the present invention relates to a method for the two-dimensional representation of volume data of a body part, in particular of the jaw, of a patient, the volume data being recorded by means of a tomographic recording device, in particular a "cone beam CT" device, the volume data being assigned three-dimensional planning data which in particular geometric data of an implant to be used, such as its position, alignment, length and diameter, wherein in the volume data a projection layer is defined, which is presented in particular by a development as a panoramic image in the presentation plane.
  • Dental implants are known to be designed using X-ray images taken over three dimensions, especially with a Cone Beam device. For this purpose, differently oriented slice views are calculated and displayed from the volume data, in which the position of the virtual implants can be determined.
  • a panoramic image such as an orthopantomogram (OPG) known to the dentist, is generated from the volume data.
  • OPG orthopantomogram
  • Such a panoramic view provides an overview of the complete dental status of the patient.
  • the shape of the curve (panoramic line), along which the panoramic image is created, can be defined freely within a plane parallel to the ground.
  • a panoramic layer generated by vertical displacement of the panoramic line and a panoramic projection are represented by the averaging summation of the Absorption coefficient of the volume perpendicular to a panoramic layer arises to distinguish.
  • Such a panoramic projection ie the averaging over many panoramic layers, simulates the representation of an OPG, wherein the depth information is missing because of the summation over all layers.
  • the implants displayed in the volume data set and defined by their planning data can also be displayed in the panoramic image.
  • Such an illustration allows the dentist to quickly assess the situation regarding the number and location of the implants in the patient's jaw.
  • the sections of the panoramic layer with the implants can be displayed.
  • panoramic projection and panoramic layer can be used to arrange the implants. This can be done by the user clicking on a location in the panoramic projection or the panoramic layer and thus placing the virtual implant in the 3D volume at that location of the panoramic layer.
  • the implant axis has always been aligned vertically.
  • the known panoramic images are only conditionally suitable for assessing the actual position and orientation of the virtual implants in the bone, since inclined implants are distorted or obliquely cut. These representations are therefore primarily the first overview of the anatomy and not the planned implants. Since the panoramic layer does not necessarily cut all implants, not all implants are visible in the panoramic layer. Due to a tilt, the implants are cut obliquely and appear in the panoramic layer as ellipses.
  • the US 6,493,415 describes a method for emitting a vertically curved panoramic layer. Each real tooth present is shown substantially along its full length. The orientation of this panoramic layer does not take into account planned implants.
  • the object of the invention is therefore to provide a generic method that can be easily implemented and can be achieved with the fact that the doctor has always during the planning of implants on an optimal two-dimensional representation of the jaw under consideration of the current implant planning.
  • the basic idea of the invention is to produce a panoramic representation on the basis of an underlying panoramic layer, which is aligned at least locally on an axis of symmetry of the planned "virtual" implant, respectively, of the corresponding engagement channel provided for this implant.
  • the presentation is thus no longer based, as hitherto, on a more or less arbitrary specification or on anatomical conditions, but on the position of a planned implant.
  • the course of the projection layer to be displayed is thus adapted to the planning data or to a curved surface adapted to the planning data.
  • this orientation of the panoramic layer can be locally limited to the location of the implant and adapt to the anatomical conditions outside of this range.
  • the panoramic layer thus to a certain extent a "warp" at the site of the implant and extends in this zone of the fault by a predetermined surface of the implant.
  • the implant can be fully displayed, with the particular advantage of this approach is that a thus calibrated representation is particularly good to see how the implant is arranged in the surrounding anatomy. This allows planning errors, such as penetration into critical areas, to be avoided much better than before.
  • the doctor After the doctor has determined on the basis of the first panoramic image that the implants are still aligned correctly, it is advantageous if he can correct their position "online" on the screen, for example by clicking the mouse. If he does so, it is provided according to the invention to automatically adapt the panorama layer on which the panoramic image is based to the change in the position, the inclination, the diameter or the length of the implant that has already been used virtually. From the thus adapted panoramic view, a panorama projection over several panoramic areas can be generated again at any time.
  • a first panoramic layer which can serve as a reference for the subsequent summation, runs through defined points in the planned implant.
  • Such points are provided by an occlusal point directed toward the occlusal surface and an apical point directed towards the root, wherein the occlusal and apical points are defined in particular by the passage points of the axis of symmetry through the top surfaces of a cylinder or cone formed by the implant becomes.
  • a first panoramic layer is adapted to the course of the jawbone or to the teeth using one of the known methods.
  • This first anatomically oriented panoramic layer is then arched locally in accordance with the planning data of a planned implant at the corresponding point in order to fully include the planned implant.
  • a panorama projection can be generated from the panoramic layer by summation over several parallel layers.
  • this panoramic layer extends through the occlusal and apical points of all implants located in the considered volume.
  • the panoramic layer rejects in such a way that all implants lie on the plane formed by it.
  • the panoramic layer to the Anatomical conditions, for example, to certain axes of symmetry of the teeth to adapt.
  • the implant When a new implant is inserted into the panoramic layer or the panoramic projection, the implant initially advantageously adapts to the previously defined layer by means of a parameterization.
  • a parameterization For example, if an implant is placed, for example by clicking with the cursor on the screen between two implants located in the upper jaw, so this gets the interpolated position and inclination of the adjacent implants. Once it has been used in this way, the layer in turn adapts to the implant at any position, inclination, length or diameter change.
  • a panoramic image adapted in this way to the position of the implants has several advantages: First of all, all implants within the same panoramic layer along an axis predetermined by them, in particular their main axis, can be represented. In particular, all implants can be displayed within the same panoramic layer along its largest cross-section. As already mentioned, all implants can be displayed distortion-free within the same panoramic projection. It is advantageous that the anatomy along the largest cross section of the implants without interaction with the layer on all implants can be assessed simultaneously. By limiting the summation area, which extends in particular over the thickness of the implant, the display of the panoramic projection can be limited to the anatomical areas that are relevant for the assessment of the prospective implant strength. With the invention, a targeted assessment of bone quality in the vicinity of the implants can be performed. Since the panoramic layer interpolates the position and inclination of the already provided implants, these parameters can be derived from the adjacent implants for further implants to be added.
  • FIG. 1 a set of three-dimensional volume data 1 in the form of a cuboid is shown.
  • an xy plane 2 is picked out, in which a panorama line 3, which here tracks the bend of a jaw, is determined.
  • a shift in the z direction which takes place here for the sake of simplicity only in the vertical direction, creates a panoramic layer 4.
  • This "thin" panoramic layer 4 can be transformed in different ways, in particular by settlement, in a plane and then represents a panoramic view
  • a panoramic projection then results from the summation of a plurality of superimposed such panoramic layers 4. It is advantageous to limit the number of layers over-summed to the thickness of the set implants.
  • the initial orientation of this first panoramic layer 4 can be done with different approaches. She can, as in FIG. 1 shown by a "classic" panoramic layer, which is created by manually drawing a panoramic line in a Schrütbene, done, this panoramic layer initially has no vertical curvature. After virtual implants are inserted, the curvature of the layer gradually adapts. It is also possible to set the initial panoramic layer along the mandibular arches and the tooth roots or the teeth with vertical curvature or to align with a previously stored "average jaw". The initial shift can also be estimated based on patient parameters such as age and gender. Mixed forms of the illustrated methods are possible.
  • the initial orientation of the panoramic layer 5 on the basis of anatomical parameters of the jaw 6 and the teeth 7 is in FIG. 2a shown. If, as here, no implants are placed in the volume data set, the panoramic layer 5 assumes a predefined shape. Only after placing the implants in the record, the layer 5 adjusts to this.
  • implants 8 are planned and their position in the jaw determined ( FIG. 2b ).
  • the computer calculates a panorama layer 9 modified on the basis of the implant data, which it places through the apical 10 and the occlusal points 11 of the implants 8.
  • This panoramic layer 9 is now projected into the plane and displayed on the screen.
  • the dentist notes due to the anatomical conditions in the environment of the implants and here also because of the not shown in the panoramic view teeth 12, which lie in the area A outside the panoramic layer 9, that the implants 8 are crooked. Then he tilts the planned implants 8 by a mouse click on the screen and corrects their position until the panoramic layer 13 ( Figure 2c ) passes through the teeth 11 and the implants are placed correctly in the jaw 6.
  • the new implants can be placed in the unrolled panoramic projection or the panoramic layer by clicking with the mouse. It is up to you the implants placed in this way after the panoramic layer already defined by the other implants. The inclination of the implants is also taken into account. The user clicks on the point where the occlusal point of the implant should come to rest. The more implants are already in the planning, the more accurate the alignment of newly added implants becomes. If the length of the implant is subsequently changed, only the apical point of the implant shifts; the occlusal point does not change its position.
  • FIG. 3 Various types of adaptation of the panoramic layer 14 to a cylindrical implant 15 are shown.
  • This implant 15 is shown in side elevation in the left column.
  • a only the occlusal 16 and the apical point 17 of the implant are passed through the panoramic layer 14.
  • the complete implant axis is traversed between the occlusal and the apical point, whereby the panoramic layer 14 within the implant can still be curved horizontally.
  • the panoramic layer 14 cuts the implant 15 along its largest cross-section.
  • the creation of the panoramic projection ie the averaged sum over several layers, automatically to a region 16 perpendicular to the panoramic layer 13 (FIG. Figure 3c ), which is located in the immediate vicinity of the implants.
  • the panoramic projection receives only the necessary information for the evaluation of the implant position on the adjacent anatomical structures and is not superimposed by insignificant information.
  • a suitable safety area 17 the areas which lie directly in front of and behind the implants 18 will be included. This can also be achieved for implants of different thicknesses by adapting the thickness of the summation area to the thickness of the implants accordingly.
  • Such a summation over the width of the implants is advantageous because only the anatomy affected by the implants is displayed in the panoramic image.
  • the layer as a whole can be moved parallel to the implant axes "forwards and backwards".
  • the layer is shifted at each point by the same distance along its normal.
  • a global shift of the layer allows all implants to be evaluated at the same time, no matter how many implants are planned. This allows a much faster, since parallel assessment of the bone around the implants are made.

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Dentistry (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Epidemiology (AREA)
  • Medical Informatics (AREA)
  • Optics & Photonics (AREA)
  • Engineering & Computer Science (AREA)
  • Physics & Mathematics (AREA)
  • Biophysics (AREA)
  • High Energy & Nuclear Physics (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Pathology (AREA)
  • Radiology & Medical Imaging (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Molecular Biology (AREA)
  • Surgery (AREA)
  • Apparatus For Radiation Diagnosis (AREA)
  • Image Generation (AREA)

Claims (9)

  1. Procédé de représentation bidimensionnelle de données volumiques (1) d'une mâchoire d'un patient, sachant que les données volumiques (1) sont prises au moyen d'un appareil de prise de vue tomographique, sachant que des données d'implantation tridimensionnelles sont assignées aux données volumiques, lesquelles présentent des données géométriques d'au moins un implant (8) à mettre en place, sachant qu'une couche panoramique à représenter (9) est définie dans les données volumiques, laquelle est présentée en tant que prise de vue panoramique dans le plan de représentation,
    et qu'une couche panoramique initiale (5) est d'abord déterminée, à l'aide de ses implants et de leur position dans la mâchoire,
    caractérisé en ce
    qu'en partant de la couche panoramique initiale (5) à l'aide de la position et des données géométriques des implants, la couche panoramique à représenter (9) est calculée, qui est placée par les points apicaux et occlusifs (10, 11) des implants, sachant que la couche panoramique à représenter (9) est courbée horizontalement et verticalement au moins localement,
    que l'alignement de la couche panoramique à représenter est adapté automatiquement à une modification de position, d'inclinaison, de longueur ou de diamètre par un algorithme fonctionnant sur un ordinateur.
  2. Procédé selon la revendication 1,
    caractérisé en ce
    que le tracé de la couche panoramique à représenter (9) est aligné sur une surface courbe adaptée aux données d'implantation.
  3. Procédé selon la revendication 1 ou 2,
    caractérisé en ce
    que la couche panoramique à représenter (9) est alignée sur tous les implants (8) virtuels se trouvant dans les donnés d'implantation.
  4. Procédé selon l'une des revendications précédentes,
    caractérisé en ce que
    de nouveaux implants (8) sont mis en place dans la couche panoramique à représenter (9) ou dans la projection panoramique par une saisie sur l'écran, en particulier par un clic de souris.
  5. Procédé selon la revendication 4,
    caractérisé en ce
    que la position et/ou l'inclinaison des implants (8) ajoutés est/sont alignée(s) automatiquement à la couche panoramique (4) définie par des implants (8) déjà mis en place.
  6. Procédé selon l'une des revendications précédentes,
    caractérisé en ce
    que lorsqu'une projection panoramique est créée, c'est-à-dire la somme calculée sur plusieurs couches panoramiques sur une zone d'addition, l'épaisseur d'une zone d'addition est alignée sur l'épaisseur des implants (8) déjà mis en place.
  7. Procédé selon la revendication 6,
    caractérisé en ce que
    l'épaisseur de la zone d'addition est élargie d'une zone de sûreté (17).
  8. Procédé selon l'une des revendications précédentes,
    caractérisé en ce
    que les données volumiques (1) sont prises via un appareil « cone beam CT ».
  9. Procédé selon l'une des revendications précédentes,
    caractérisé en ce
    que la couche panoramique est présentée par un développement en tant que prise de vue panoramique dans le plan de représentation.
EP06828885.1A 2005-11-14 2006-10-30 Enregistrements panoramiques stratifies en vue de la planification d'une implantation Active EP1948061B1 (fr)

Applications Claiming Priority (3)

Application Number Priority Date Filing Date Title
DE102005054571 2005-11-14
DE102005055896A DE102005055896B4 (de) 2005-11-14 2005-11-22 Panoramaschichtaufnahmen zur Implantatplanung
PCT/EP2006/010415 WO2007054219A1 (fr) 2005-11-14 2006-10-30 Enregistrements panoramiques stratifies en vue de la planification d'une implantation

Publications (2)

Publication Number Publication Date
EP1948061A1 EP1948061A1 (fr) 2008-07-30
EP1948061B1 true EP1948061B1 (fr) 2014-01-01

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EP (1) EP1948061B1 (fr)
KR (1) KR101326471B1 (fr)
DE (1) DE102005055896B4 (fr)
WO (1) WO2007054219A1 (fr)

Families Citing this family (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE102007051719A1 (de) * 2007-10-30 2009-05-07 Sicat Gmbh & Co. Kg Schichtaufnahmen zur Implantatplanung
DE102008008733A1 (de) * 2008-02-12 2009-08-13 Sirona Dental Systems Gmbh Verfahren zur Erstellung einer Schichtaufnahme
DE102008021926B4 (de) * 2008-05-02 2019-01-03 Sicat Gmbh & Co. Kg Erstellung und Präsentation von patientenindividuellen Panoramadarstellungen
KR101067359B1 (ko) * 2009-12-14 2011-09-23 경희대학교 산학협력단 드릴 가이드홀 형성방법, 수술 가이드의 가이드 몸체 및 가이드 지그
DE102014205820A1 (de) * 2014-03-28 2015-10-01 Siemens Aktiengesellschaft Schichtdarstellung mit effizienter Festlegung der Schichtorientierung
KR102191798B1 (ko) 2018-12-12 2020-12-16 경북대학교 산학협력단 임플란트 수술결과 평가방법 및 장치, 그를 위한 스캔정보 획득방법
WO2022039506A1 (fr) 2020-08-19 2022-02-24 주식회사 미토이뮨테라퓨틱스 Antioxydant ciblant les mitochondries en tant qu'agent pour le traitement d'une inflammation pathologique provoquée par une infection à mabc-r

Citations (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US6493415B1 (en) * 1999-03-25 2002-12-10 Nihon University X-ray computed tomography method and apparatus

Family Cites Families (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
MXPA03006790A (es) * 2001-02-07 2003-11-13 Synthes Ag Metodo para establecer una representacion tridimensional de un hueso a partir de imagenes de rayos x.
DE10338145B4 (de) * 2003-08-15 2022-02-24 "Stiftung Caesar" (Center Of Advanced European Studies And Research) Verfahren zur Darstellung von 3D Bilddaten

Patent Citations (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US6493415B1 (en) * 1999-03-25 2002-12-10 Nihon University X-ray computed tomography method and apparatus

Also Published As

Publication number Publication date
DE102005055896B4 (de) 2013-11-21
KR20080080519A (ko) 2008-09-04
KR101326471B1 (ko) 2013-11-07
DE102005055896A1 (de) 2007-05-16
EP1948061A1 (fr) 2008-07-30
WO2007054219A1 (fr) 2007-05-18

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